An I:E Ratio : 1:1 or 1:1 1/4 with a pause in between inspiration & expiration

Thoracic Geography : sternocostal margins, over the verbral column between the scapulae

Sound Characteristics : high pitched, tubular, hollow sound

Indication : pneumonia, atelectasis, fluid infiltration

Adventitious Sounds

Rales or crackles is a sound that is a discontinuous sound that is like a milkshake being sucked up through a straw, or popcorn popping in a popcorn popper, or like aerial bombs going off on the 4th of July,
or the sound that you hear when burning wood crackles and pops in a fireplace. When fluid or mucus collects in the peripheral portions of the lung, the alveoli collapse and the walls of the alveoli stick together. Then,
when the patient attempts to inhale and creates a large negative, the alveolar walls are forced to pop open and the crackle or the popping sound is created. This is a sound heard during inspiration. If it is heard anywhere
on the chest wall, it is an ominous sound. It is indicative of a pneumonia or an atelectatic lung.

Pleural Friction Rubs are created when the visceral and parietal pleurae become inflammed and roughened. The inflammed
membranes will stick together. As the therapist auscultates the chest wall, the rubbing together of the inflammed
membranes will cause the patient to experience pain and stop breathing - a maneuver called splinting. The pain is caused by the sticking together of the membranes and the pulling apart of those membranes with continued breathing.
Once the membranes slip past one another and break free from the sticking point, then the patient is pain-free and inhalation or exhalation can continue. The sound that a pleural friction rub makes is a leather-on-leather type of sound.
These sounds can be heard at the same points in the inhalatory and the exhalatory cycles.

The Death Rattle is an ominous sound that generally describes a patient with lungs that are filling up with fluid. The death rattle
is produced by passing air through secretions. It can generally be heard eminating from a patient without the use of a stethoscope. It often
can be heard from the hall as you pass the patient's room.

Stridor is a high pitched wheezing that is caused by the obstruction of the trachea either by inflammation or an object. Just enough air passes
the obstructed point to cause a high-pitched whining wheeze. In children, stridor is most frequently caused by croupe, a viral infection that causes the
tracheal membranes to swell to a near-closed position. The wheeze is produced much like a wind instrument produces sound through a
wooden reed. In children, croupe can be a life-threatening condition which can cause death if the trachea closes off to tightly. Other reasons why stridor is seen very often in
children is due to their propensity to inhale a toy into their trachea.

Rhonchi or Wheezes appear in two varieties - a sibilant wheeze and a sonorous wheeze. The wheezes are considered to be central airway sounds caused by
air passing through mucus plugs in the upper divisions of the tracheobronchial tree. The sibilant wheeze is a high-pitched whining type of wheeze much like the sound that hump-back whales make as they migrate.
The sonorous wheeze is a snoring type of sound.

Egophony is the Greek word for "Voice of the Goat". This sound is the "EEEEE" to "AAAAA" conversion that a person will make when
being asked to say "EEEEE" while the auscultator listens to the lungs which is heard by the auscultator as "AAAAA" through the stethoscope.

Whispered Pectoriloquy is the sound that is heard through the stethoscope by the auscultator when the patient whispers a word or a number. Normally,
whispered sounds are not heard through the chest wall. Because of fluid buildup in the alveolar regions of the lung, the whispered
sound can be heard distinctly.